Predictors of viral suppression among youth living with HIV in the southern United States

ABSTRACT

Youth living with HIV (YLH) in the United States (U.S.) face significant problems with achieving viral suppression, especially in the South. To examine this issue, YLH with a detectable viral load (N = 61) were recruited from the southern U.S and assessed over 16 weeks for health and treatment factors. Participants were part of a smartphone-based intervention trial. Analyses focused on predictors of viral suppression controlling for intervention effects. Fifty-three percent achieved suppression. In univariate models, YLH who engaged in condomless sex four to 16 weeks into the study (odds ratio [OR] = 4.00; compared to those who did not) and self-reported ≥ 90% antiretroviral adherence in the first four weeks of the study (OR = 25.00; compared to youth with <90%) had a higher likelihood of suppression. Shifts in adherence-related social support (OR = 4.98) and appointments kept (OR = 2.72) were also associated with suppression. YLH endorsing illicit drug use had a lower likelihood of suppression (OR = 0.16; compared to those without use). Effects (except drug use) remained significant or approached significance in a multivariate model. Adherence promotion efforts should consider this population’s adherence-related social support, drug use, and risk for sexually transmitted infections.

KEYWORDS:

• HIV
• adolescent
• young adult
• adherence
• antiretroviral
• viral load

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Research for this publication was supported by the National Institutes of Health under Award Numbers R01HD074848 (PI: Brown) and K23MH114632 (PI: Tarantino). This work was also facilitated by the Providence/Boston Center for AIDS Research with support from the National Institute of Allergies and Infectious Diseases (P30AI042853; PI: Cu-Uvin). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.